A cheap and painless set of tests developed in leading medical centers around the country promises to predict heart disease and stroke, and pinpoint the patients who really need aggressive therapy, far more accurately than do the traditional risk factors.
The new method includes a simple measurement of the difference in blood pressure between arms and ankles, and a noninvasive acoustic test that measures narrowing of the carotid arteries that carry blood to the brain.
Many patients with high cholesterol levels do not in fact develop heart disease. Conversely, there are also many patients who develop silent heart disease without having any of the known risk factors like high cholesterol, smoking and diabetes. The scientists hope the new test will focus attention on patients in both categories who are most at risk.
“You don’t necessarily have to apply aggressive treatment to everyone with bad risk factors,” said Dr. Lewis Kuller, an epidemiologist at the University of Pittsburgh. Kuller helped develop the new method as part of an ongoing study of the emergence of cardiovascular disease in people 65 and older.
He predicted that the technique would prove most useful for people over 60, especially those with high cholesterol, and for people of any age whose doctors think they may need drugs to help lower blood cholesterol or triglycerides, another fatty component of the blood. He also said the screening technique could be useful for people with moderately elevated systolic blood pressure (measured by the larger of the two blood pressure numbers) and for children and young adults with a strong family history of cardiovascular disease.
Without so much as a needle prick, the method indirectly measures the extent of hidden atherosclerosis, or clogging of the arteries, in people who have no outward symptoms of cardiovascular disease, such as chest pains.
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